Quality Improvement in Restraint Practices Among Residential Programs

 

          Principal Investigator: J. Curtis McMillen, Ph.D.

          Funder: CMHSR funded pilot (through NIMH - P30 MH068579)

          Timeframe: 4/05-09/06

          Affiliation: Center for Mental Health Services Research (CMHSR)

Project Staff:  Bethany Lee, MSW and NIMH pre-doctoral trainee

                        Nicole Fedoravicius, MPH, Qualitative Research Specialist

                        Norma Ware, Ph.D., Qualitative Methods Unit Leader

                        Toni Tugenberg, M.Ed., LICSW, Qualitative Methods Team

                       

Participating Organizations: Missouri Children's Division, Missouri Childcare

                                                Association                                                

Project Contact:   J. Curtis McMillen, Ph.D., 314-935-7517

                              Email: cmcmille@wustl.edu

 

Project Update as of 4/20/05:
Stage: Completed

 

Description:  The use of physical restraint in mental health facilities rose to a national concern following a 1998 five-part series in the Hartford Courant that estimated between 50 and 100 persons died each year as a result of physical restraint in mental health facilities.  Soon after the release of the series several state and national efforts to reduce the use of and tighten the standards for physical restraints began. 

 

The project will serve to inform a quality improvement effort by the Missouri Children's Division to lessen the use of physical restraint in the residential programs they license and regulate and that serve the children and youth in their care.

 

The aims of the project are to:

1. Increase understanding of the variability of restraint use in Missouri's residential programs.

2. Increase understanding of the variation in program-level policies on the use of restraints in these facilities.

3. Improve understanding of stakeholder views on the use of restraints at Missouri residential  programs.

4. Improve understanding of the acceptability to residential providers of potential quality improvement activities related to the use of restraint.

 

The proposed pilot work also involves several small data collection efforts that include the following: the abstraction of archival information on the use of restraint at selected facilities; review of residential programs' written policies on the use of physical restraint; interviews with youth consumers; presentation of findings to residential providers at a statewide meeting designed to address next steps in this process.

 

Progress in ACISR Year 1, 9/22/05-7/31/05: The team is actively planning implementation and awaiting Human Subjects Approval from Washington University's Internal Review Board (IRB).

Plans for ACISR Year 2, 8/01/05-7/31/06:  The PI hopes to conduct subsequent pilot work and future RO1s related to the care provided in Missouri's residential programs for youth.  The PI also aims to publish one article on stakeholder views of the use of physical restraint in residential programs for youth.